Article information
Resumen
El síndrome antifosfolipídico (SAF) es una reconocida causa de complicaciones en el embarazo, como la trombosis materna, la preeclampsia y la mortalidad embriofetal. El tratamiento de las mujeres embarazadas con SAF exige un abordaje multidisciplinario médico-obstétrico, así como intervención terapéutica basada en la combinación de ácido acetilsalicílico y heparina. Si bien las pautas concretas son discutibles por las importantes limitaciones de los estudios existentes, hay cierto grado de consenso en la recomendación del tratamiento combinado en mujeres con trombosis y/o muertes fetales previas. Las pacientes con historia exclusiva de abortos tempranos son el grupo en el que más se debate sobre la actitud a seguir, si bien el ácido acetilsalicílico en monoterapia sigue siendo una opción. En cualquiera de las situaciones, es fundamental una correcta tromboprofilaxis periparto en todas las mujeres con anticuerpos antifosfolipídicos.
Palabras clave:
Síndrome antifosfolipídico
Gestación
Aborto
Abstract
The antiphospholipid syndrome (APS) is a well known cause of pregnancy complications, including maternal thrombosis and preeclampsia as well as embryofetal losses. A multidisciplinary, medical-obstetric approach is of great importance in the clinical management of pregnant women with APS. Therapeutic interventions are based on the combination acilsalycilic acid-heparin. Although the specific combinations in different situations are still a matter of debate – due to important limitations of the available studies–, combined treatment with both drugs is usually recommended in women with previous thrombosis and/or fetal death. Aspirin alone is still a reasonable option for women with early losses, although controversy is particularly important in this group. In any situation, an adequate thromboprophylaxis in the peripartum period is warranted.
Key words:
Antiphospholipid Syndrome
Pregnancy
Miscarriage
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